A new report examines the preparedness of states for different emergencies, including plans to evacuate children from schools, vaccination requirements, disease outbreaks, the ability to deal with chemical terrorism, staffing for a prolonged infectious disease outbreak, having a multi-hazard written evacuation plan, Medicaid coverage of flu shots, nurses’ ability to work in other states, and other emergency factors; the report found that only five states met eight of the ten measures used to evaluate public health preparedness

According to a report released on Wednesday, only five states met eight of ten measures used to evaluate public health preparedness, which includes everything from tainted food to hurricanes and tornados.

The measures examined plans to evacuate children from schools, vaccination requirements, disease outbreaks, the ability to deal with chemical terrorism, staffing for a prolonged infectious disease outbreak, having a multi-hazard written evacuation plan, Medicaid coverage of flu shots, nurses’ ability to work in other states, and other emergency factors.

Montana, Nevada, Colorado, Kansas, Georgia, New Jersey, and Hawaii received the lowest scores as they met only three to four of the ten measures. States with the highest scores were Maryland, Mississippi, North Carolina, Vermont, and Wisconsin.

Most states with average to low scores have had to deal with massive budget cuts in their public health systems.

Twenty-nine states have cut public health budgets in the last three years and twenty-three states cut their budgets for the second year in a row, but the states with the highest scores have increased or maintained their health budgets.

“Investments made after Sept. 11, the anthrax attacks and Hurricane Katrina led to dramatic improvements, but now budget cuts and complacency are our biggest threats,” Jeffrey Levi, executive director of the Trust for America’s Health told USA Today. “Since then, there have been a series of significant health emergencies, but we haven’t learned that we need to bolster and maintain a consistent level of health emergency preparedness.”

The authors of the report say the county has not paid “sufficient” attention to the “the everyday threats public health departments and health care providers face repeatedly.” Besides whether related disasters and foodborne illnesses, “we have suffered a deadly rise of West Nile virus, a fungal meningitis outbreak and a resurgence of old diseases we thought were largely conquered — whooping cough and tuberculosis — all in a growing era of antibiotic resistance.”

“This study doesn’t paint a pretty picture,” Kathleen Tierney, director of the National Hazards Center at the University of Colorado in Boulder, told USA Today. “You have to be able to invest in sustaining problems, keep up with emerging problems, keep up with state of the art equipment, and learn what best practices are out there,” Tierney added. “Even for states that are maintaining their budget that really means their budget is going down because costs are increasing.”

According to Jim Blumenstock, chief program officer for Public Health Practice at the Association of State and Territorial Health Officials, the report exposes the nation’s inability to address an expanding list of hazards.

“It would be nice if we could say we’re no longer concerned about bioterrorism, it’s Mother Nature we have to face,” Blumenstock told USA Today. “But no, we have to be ready to address bioterrorism, severe storm events, and even random occurrences of violence, like we’re experiencing in Connecticut at Sandy Hook.”

Not everyone agrees with the report. Florida’s director of public health, John Armstrong, said that although the state’s budget has been trimmed by 15.5 percent, “the Florida Department of Health has had and continues to have the resources necessary to accomplish our public health functions in Florida.”